Universität zu Köln

Evans, Scott R., Hujer, Andrea M., Jiang, Hongyu, Hill, Carol B., Hujer, Kristine M., Mediavilla, Jose R., Manca, Claudia, Tran, Thuy Tien T., Domitrovic, T. Nicholas, Higgins, Paul G. ORCID: 0000-0001-8677-9454, Seifert, Harald, Kreiswirth, Barry N., Patel, Robin, Jacobs, Michael R., Chen, Liang, Sampath, Rangarajan, Hall, Thomas, Marzan, Christine, Fowler, Vance G., Jr., Chambers, Henry F. and Bonomo, Robert A. (2017). Informing Antibiotic Treatment Decisions: Evaluating Rapid Molecular Diagnostics To Identify Susceptibility and Resistance to Carbapenems against Acinetobacter spp. in PRIMERS III. J. Clin. Microbiol., 55 (1). S. 134 - 145. WASHINGTON: AMER SOC MICROBIOLOGY. ISSN 1098-660X

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Abstract

The widespread dissemination of carbapenem-resistant Acinetobacter spp. has created significant therapeutic challenges. At present, rapid molecular diagnostics (RMDs) that can identify this phenotype are not commercially available. Two RMD platforms, PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS) and molecular beacons (MB), for detecting genes conferring resistance/susceptibility to carbapenems in Acinetobacter spp. were evaluated. An archived collection of 200 clinical Acinetobacter sp. isolates was tested. Predictive values for susceptibility and resistance were estimated as a function of susceptibility prevalence and were based on the absence or presence of beta-lactamase (bla) NDM, VIM, IMP, KPC, and OXA carbapenemase genes (e.g., bla(OXA-23), bla(OXA-24/40), and bla(OXA-58) found in this study) against the reference standard of MIC determinations. According to the interpretation of MICs, 49% (n = 98) of the isolates were carbapenem resistant (as defined by either resistance or intermediate resistance to imipenem). The susceptibility sensitivities (95% confidence interval [CI]) for imipenem were 82% (74%, 89%) and 92% (85%, 97%) for PCR/ESI-MS and MB, respectively. Resistance sensitivities (95% CI) for imipenem were 95% (88%, 98%) and 88% (80%, 94%) for PCR/ESI-MS and MB, respectively. PRIMERS III establishes that RMDs can discriminate between carbapenem resistance and susceptibility in Acinetobacter spp. In the context of a known prevalence of resistance, SPVs and RPVs can inform clinicians regarding the best choice for empiric antimicrobial therapy against this multidrug-resistant pathogen.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Evans, Scott R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hujer, Andrea M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jiang, Hongyu UNSPECIFIED UNSPECIFIED UNSPECIFIED Hill, Carol B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hujer, Kristine M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mediavilla, Jose R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Manca, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Tran, Thuy Tien T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Domitrovic, T. Nicholas UNSPECIFIED UNSPECIFIED UNSPECIFIED Higgins, Paul G. UNSPECIFIED orcid.org/0000-0001-8677-9454 UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreiswirth, Barry N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Patel, Robin UNSPECIFIED UNSPECIFIED UNSPECIFIED Jacobs, Michael R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chen, Liang UNSPECIFIED UNSPECIFIED UNSPECIFIED Sampath, Rangarajan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hall, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Marzan, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Fowler, Vance G., Jr. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chambers, Henry F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonomo, Robert A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-243580
DOI:	10.1128/JCM.01524-16
Journal or Publication Title:	J. Clin. Microbiol.
Volume:	55
Number:	1
Page Range:	S. 134 - 145
Date:	2017
Publisher:	AMER SOC MICROBIOLOGY
Place of Publication:	WASHINGTON
ISSN:	1098-660X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PREVALENT OXA CARBAPENEMASES; MULTIPLEX PCR; BAUMANNII; GENES; DIFFERENTIATE Multiple languages Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24358